Using data from the National Vital Statistics System and the US Census Bureau, the researchers reported that from 1999 to 2015, the annual suicide rate increased by 14%, from 12.6 to 14.4 per 100, 000 US residents aged 10 years or older.

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Higher suicide rates in less urban areas could be linked with limited access to mental health care, the opioid overdose epidemic, and social isolation, the investigators suggested. The 2007-2009 economic recession may have caused the sharp upswing, they added, because rural areas and small towns were hardest hit.